Healthcare Provider Details

I. General information

NPI: 1841790318
Provider Name (Legal Business Name): SPENCER NOORDA FOOT AND ANKLE L.L.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/20/2018
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68 N PECOS RD STE A
HENDERSON NV
89074-7340
US

IV. Provider business mailing address

68 N PECOS RD STE A
HENDERSON NV
89074-7340
US

V. Phone/Fax

Practice location:
  • Phone: 702-456-1441
  • Fax:
Mailing address:
  • Phone: 702-456-1441
  • Fax: 702-456-3901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License Number2018
License Number StateNV
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number2018
License Number StateNV
# 3
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License Number2018
License Number StateNV
# 4
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number2018
License Number StateNV
# 5
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number2018
License Number StateNV
# 6
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number2018
License Number StateNV

VIII. Authorized Official

Name: SPENCER NOORDA
Title or Position: OWNER
Credential: DPM
Phone: 702-456-1441